WO1998008510A1 - Use of inhibitors of pkc for the manufacture of a medicament for the treatment of central nervous system diseases associated with hiv infection - Google Patents
Use of inhibitors of pkc for the manufacture of a medicament for the treatment of central nervous system diseases associated with hiv infection Download PDFInfo
- Publication number
- WO1998008510A1 WO1998008510A1 PCT/US1997/015583 US9715583W WO9808510A1 WO 1998008510 A1 WO1998008510 A1 WO 1998008510A1 US 9715583 W US9715583 W US 9715583W WO 9808510 A1 WO9808510 A1 WO 9808510A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- alkyl
- inhibitor
- independently
- protein kinase
- hydrogen
- Prior art date
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- 0 *C(*[n]1c2ccccc2c(C(C(N2)=O)=C3C2=O)c1)*[n]1c2ccccc2c3c1 Chemical compound *C(*[n]1c2ccccc2c(C(C(N2)=O)=C3C2=O)c1)*[n]1c2ccccc2c3c1 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
- A61K31/407—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with other heterocyclic ring systems, e.g. ketorolac, physostigmine
Definitions
- the present invention is broadly directed to the use of a particular class of isozyme
- PLC Protein Kinase C
- Acute HTV infection leads to a period of rapid viral replication, followed by viremia that results in infection of 1% or more of circulating T lymphocytes, the primary target of the virus.
- Viremia is transient, however, because the cells infected with HIV are removed from circulation by an effective host immune response that results in a 10- to 100-fold decrease in the HTV-infected T cells.
- no effective therapy yet exists for preventing viral activation after exposure.
- the initial host response is effective in reducing and controlling HTV-infected cell numbers, it is not sufficient to
- LLP postintegration latent or low-level-persistent
- host reservoir cells such as circulating CD4+ T lymphocytes and monocyte/macrophages.
- AIDS acquired immune deficiency syndrome
- Central nervous system (CNS) disease is a prominent feature of HTV infected patients manifesting AIDS symptamolog . Symptoms related to this CNS affliction include paralysis, dementia and death. While HTV associated CNS disease occurs in the setting of HIV infection, the etiology of the illness is likely due to the host response to the virus rather than to a direct viral cytolytic effect.
- a particular class of protein kinase C inhibitors i.e., inhibitors of the ⁇ isozyme of protein kinase C, and especially ⁇ isozyme selective inhibitors of PKC, has therapeutic effects on CNS diseases associated with HIV infection and specifically retards the effect that gpl20 exerts on the HTV infected patient.
- gpl20 is a product of the HIV genome that is shed into the extracellular space from HIV infected cells. gpl20 can induce both in vitro and in vivo neurotoxicity (Gendilman et al., 1994, J. Leukocyte Biol. 56:389-398; Crow et al., 1994, J.
- gpl20 positive astroglial cells especially reactive astrocytosis or alternatively termed reactive gliosis, have been implicated in the CNS damage that leads to the CNS manifestations seen in HIV infected patients.
- gpl20 is known to activate PKC. PKC activity is up modulated in gpl20 positive HTV-1 transfected cells, in the CNS of gpl20 transgenic mice, and in the specimens from the brains of HTV infected patients.
- GFAP steady state glial fibrillary acidic protein
- HTV related CNS neurotoxicity is due to gpl20 induced PKC activation and reactive gliosis.
- the PKC pathway is a necessary component in the reactive gliosis that occurs in patients with HTV related CNS diseases.
- the ability of PKC inhibitors to block gpl20 induced astroglial cell activation demonstrates that a therapy specifically interfering with the PKC pathway could block the reactive astroglisosis and its concomitant neurotoxicity which leads to the clinical symptomology associated with HIV related CNS disease. Therefore, the present invention proposes PKC inhibitor compounds, exhibiting selectively for the ⁇ isozyme, for use therapeutically to retard or halt progression of CNS disorders and decrease the paralysis, dementia and death associated with HIV related CNS complications.
- the method of this invention preferably utilizes those protein kinase C inhibitors that effectively inhibit the ⁇ isozyme.
- One suitable group of compounds are generally described
- bis-indolylmaleimides or macrocyclic bis-indolylmaleimides.
- Bis- indolylmaleimides well recognized in the prior art include those compounds described in
- One preferred class of compounds for use in the method of the invention has the
- W is -O-, -S-, -SO-, -SO 2 -, -CO-, Cj-C 6 alkylene, substituted alkylene, C 2 -C 6 alkenylene, -aryl-, -aryl(CH 2 ) m O-, -heterocycle-, -heterocycle-(CH ⁇ resortp-, -fiised bicyclic-, -fused bicycHc-(CH 2 ) m O-, -NR 3 -, -NOR 3 -, -CONH-, or -NHCO-;
- X and Y are independently C,-C 4 alkylene, substituted alkylene, or together X, Y, and W combine to form -(CH ⁇ -AA-;
- R * s are hydrogen or up to four optional substituents independently selected from halo, C,-C 4 alkyl, hydroxy, C r C 4 alkoxy, haloalkyl, nitro, -NR 4 R 5 , or -NHCO(C,-C 4 alkyl);
- R 2 is hydrogen, CH 3 CO-, -NH 2 , or hydroxy;
- R 3 is hydrogen, -(CH ⁇ aryl, -C r C 4 alkyl, -COO ⁇ -C, alkyl), -CONR 4 R 5 ,
- R* and R s are independently hydrogen, C,-C 4 aUcyl, phenyl, benzyl, or combine with the nitrogen to which they are bonded to form a saturated or unsaturated 5 or 6 member
- AA is an amino acid residue
- m is independently 0, 1, 2, or 3
- n is independently 2, 3, 4, or 5
- a more preferred class of compounds for use in this invention is represented by formula I wherein the moieties -X-W-Y- contain 4 to 8 atoms, which may be substituted or unsubstituted. Most preferably, the moieties -X-W-Y- contain 6 atoms.
- Other preferred compounds for use in the method of this invention are those
- R 1 and R 2 are hydrogen; and W is a substituted alkylene, -O-, S-, -CONH-, -NHCO- or -NR 3 -.
- Particularly preferred compounds for use in the invention are compounds of the formula la:
- Z is -(CH-) ⁇ - or - C ⁇ - p -O-(CH j) réelle-;
- R 4 is hydroxy, -SH, C , -C 4 alkyl, (CH 2 ) m aryl, -NH(aryl), -N(CH 3 ) (CF 3 ), -NH(CF 3 ), or -NR S R 6 ;
- R 5 is hydrogen or C,-C 4 alkyl;
- R 6 is hydrogen, CyC, alkyl or benzyl;
- p is 0, 1, or 2; and
- m is independently 2 or 3, or a pharmaceutically acceptable salt, prodrug or ester thereof.
- Most preferred compounds of the formula la are those wherein Z is CH 2 ; and R 4 is -NH 2 , -NH(CF 3 ), or -N(CH 3 ) 2 , or a
- Z is -(CHj),,-;
- R 4 is -NR J R 6 , -NH(CF 3 ), or -N(CH 3 ) (CF 3 );
- R s and R 6 are independently H or -Q alkyl; p is 0, 1, or 2; and m is independently 2 or 3, or a
- Most preferred compounds of formula lb are those wherein p is 1; and R 5 and R 6 are methyl.
- the compounds of formulae I, la, and lb can also exist as pharmaceutically acceptable acid addition salts.
- Acids commonly employed to form such salts include inorganic acids such as hydrochloric, hydrobromic, hydroiodic, sulfuric and phosphoric acid, as well as organic acids such as para-toluenesulfonic, methanesulfonic, oxalic, para-bromophenylsulfonic, carbonic, succinic, citric, benzoic, acetic acid, and related inorganic and organic acids.
- Such pharmaceutically acceptable salts thus include sulfate, pyrosulfate, bisulfate, sulfite, bisulfite, phosphate, mono-hydrogenphosphate, dihydrogenphosphate, metaphosphate, pyrophosphate, chloride, bromide, iodide, acetate, propionate, decanoate, caprylate, acrylate, formate, isobutyrate, heptanoate, propiolate,
- the pharmaceutically acceptable salts of compounds of formulae I, la, and lb can also exist as various solvates, such as with water, methanol, ethanol, dimethylformamide, ethyl acetate and the like. Mixtures of such solvates can also be prepared.
- the source of such solvate can be from the solvent of crystallization, inherent in the solvent of preparation or crystallization, or adventitious to such solvent.
- a prodrug is a drug which has been chemically modified and may be biologically inactive at its site of action, but which may be degraded or modified by one or more enzymatic or other in vivo processes to the parent bioactive form.
- This prodrug likdy may have a different pharmacokinetic profile than the parent, enabling easier absorption across the mucosal epithelium, better salt formation or solubility, and/or improved systemic stability (an increase in plasma half-life, for example).
- chemical modifications include the following:
- ester or amide derivatives which may be cleaved by esterases or Upases;
- One particularly preferred protein kinase - ⁇ inhibitor for use in the method of this invention is the compound described in Example 5g ((S 3,4-[N, N , -((2"-ethoxy)-3'"(O)- 4 , -(N,N-dimethylamino)-butane)-bis-(3 ,3 '-indoly 1 )]- 1 (H)-pyrrole-2,5-dione Hydrochloride Salt) of the aforementioned U.S. Patent 5,552,396.
- This compound is a potent protein kinase C inhibitor.
- a preferred mesylate salt can be prepared by reacting a compound of the formula II
- a non-reactive organic solvent preferably an organic/water mixture, and most preferably water-acetone.
- organic solvents such as methanol, acetone, ethylacetate and mixtures thereof are operable.
- the ratio of solvent to water is not critical
- Preferred solvent to water ratios are generally from 0.1 : 1 to 100: 1 solvent to water by volume.
- the ratio is 1 : 1 to 20:1 and most preferably 5:1 to 10:1.
- the optimal ratio is dependent on the solvent selected and is preferably acetone at a 9:1 solvent to water ratio.
- the reaction usually involves approximately equimolar amounts of the two reagents, although other ratios, especially those wherein the methanesulfonic acid is in excess, are operative.
- the rate of addition of methanesulfonic acid is not critical to the reaction and may be added rapidly ( ⁇ 5 minutes) or slowly over 6 or more hours.
- the reaction is carried out at temperatures ranging from 0°C to reflux.
- the reaction mixture is stirred until formation of the salt is complete, as determined by x-ray powder diffraction and can take from 5 minutes to 12 hours.
- the salts of the present invention are preferably and readily prepared as a crystalline form.
- the trihydrate form of the salt may be readily converted to the monohydrate upon drying or exposure to 20-60% relative humidity.
- the salt is substantially crystalline demonstrating a defined melting point, birefringence, and an x-ray diffraction pattern. Generally, the crystals have less than 10% amorphous solid and preferably less than 5% and
- the mesylate salt is isolated by filtration or other separation techniques appreciated in the art, directly from the reaction mixture in yields ranging from 50% to 100%. Recrystallization and other purification techniques known in the art may be used to purify
- the salt further if desired.
- a therapeutically effective amount of the protein kinase C inhibitor of the present invention is the amount sufficient to ameliorate the clinical symptomology of CNS diseases associated with HTV infection or the amount sufficient to inhibit gpl20 induced CNS disorders. It is well within the ability of a person skilled in the art to measure the gpl20 neurotoxicity including but not limited to neuronal damages associated with CNS diseases.
- the amount administered varies inter alia, depending upon the concentration of the compound in the therapeutic formulation, and the body weight of the patient. Generally, an amount of protein kinase C inhibitor to be administered as a therapeutic agent for HIV associated CNS disease will be determined on a case by case basis by the attending physician. As a guideline, the degree of infection, the
- a suitable dose is one that results in a concentration of the protein kinase C inhibitor at the treatment site in the range of 0.5 nM to 200 ⁇ M, and more usually 0.5 nM
- a patient in need of treatment likely will be administered between about 0.001 mg per day per kg of body weight and 50.0 mg per day per kg. Usually, not more than about 10.0 mg per day per kg of body weight of protein kinase C inhibitor should be needed. As noted above, the above amounts may vary on a case-by-case basis.
- GFAP glial fibrillary acidic protein
- Transgenic mice overexpressing gpl20 can be used to test the effects of the invention compounds in vivo. Using histological analysis, compounds inducing a reduction in the reactive gliosis and the concomitant neurotoxicity in gpl20 overexpressing mice would be highly predictive of a beneficial effect of the compounds in treating the CNS diseases associated with HTV infection.
- the compounds of formula I, and the preferred compounds of formula la and lb are preferably formulated prior to administration. Suitable pharmaceutical formulations are prepared by known procedures using well known and readily available ingredients.
- the active ingredient will usually be mixed with a carrier, or diluted by a carrier, or enclosed within a carrier which may be in the form of a capsule, sachet, paper or other container.
- a carrier which may be in the form of a capsule, sachet, paper or other container.
- the carrier serves as a diluent, it may be a solid, semisolid or liquid material which acts as a vehicle, excipient or medium for the active ingredient.
- compositions can be in the form of tablets, pills, powders, lozenges, sachets, cachets, elixirs, suspensions, emulsions, solutions, syrups, aerosol (as a solid or in a liquid medium), soft and hard gelatin capsules, suppositories, sterile injectable solutions and sterile packaged powders for either oral or topical application.
- suitable carriers, excipient, and diluents include lactose, dextrose, sucrose sorbitol, mannitol, starches, gum acacia, calcium phosphates, alginate, tragacanth, gelatin, calcium silicate, microcrystalline cellulose, polyvinylpyrrolidone, cellulose, water syrup, methyl cellulose, methyl and propylhydroxybenzoates, talc, magnesium stearate and mineral oil.
- the formulations can additionally include lubricating agents, wetting agents, emulsifying and suspending agents, preserving agents, sweetening agents or flavoring agents.
- compositions of the invention may be formulated so as to provide quick, sustained or delayed release of the active ingredient after administration to the patient.
- the compositions are preferably formulated in a unit dosage form, each dosage containing from about 0.05 mg to about 3 g, more usually about 750 mg of the active ingredient.
- the therapeutic dosage administered will be determined by the physician in the light of the relevant circumstances including the severity of the condition to be treated,
- unit dosage form refers to physically discrete units suitable as unitary dosages for human subjects and other mammals, each unit containing a predetermined
- the compounds used in the method of the present invention also may be administered topically.
- Topical formulations include ointments, creams and gds.
- Ointments generally are prepared using either (1) an oleaginous base, i.e., one consisting of fixed oils or hydrocarbons, such as white petrolatum or mineral oil, or (2) an absorbent base, i.e., one consisting of an anhydrous substance or substances which can absorb water, for example anhydrous lanolin.
- an oleaginous base i.e., one consisting of fixed oils or hydrocarbons, such as white petrolatum or mineral oil
- an absorbent base i.e., one consisting of an anhydrous substance or substances which can absorb water, for example anhydrous lanolin.
- the active ingredient is added to an amount affording the desired concentration.
- Creams are oil/water emulsions. They consist of an oil phase (internal phase), comprising typically fixed oils, hydrocarbons, and the like, such as waxes, petrolatum, mineral oil, and the like, and an aqueous phase (continuous phase), comprising water and any water-soluble substances, such as added salts.
- the two phases are stabilized by use of an emulsifying agent, for example, a surface active agent, such as sodium lauryl sulfate; hydrophilic colloids, such as acacia colloidal clays, veegum, and the like.
- the active ingredient customarily is added in an amount to achieve the desired concentration.
- Gels comprise a base selected from an oleaginous base, water, or an emulsion- suspension base.
- a gelling agent which forms a matrix in the base, increasing its viscosity.
- examples of gelling agents are hydroxypropyl cellulose, acrylic acid polymers, and the like.
- the active ingredient is added to the formulation at the desired concentration at a point preceding addition of the gelling agent.
- the amount of compound incorporated into a topical formulation is not critical; the concentration should be within a range sufficient to permit ready application of the formulation to the affected tissue area in an amount which will deliver the desired amount
- the customary amount of a topical formulation to be applied to an affected tissue will depend upon concentration of compound in the formulation. Generally, the formulation will be applied to the effected tissue in an amount affording from about 1 to about 500 ⁇ g compound per cm 2 of an affected tissue. Preferably, the applied amount of compound will range from about 30 to about 300 ⁇ g cm 2 , more preferably, from about 50 to about 200 ⁇ g/cm 2 , and, most preferably, from about 60 to about 100 ⁇ g/cm 2 .
- the following formulation examples are illustrative only and are not intended to limit the scope of the invention in any way.
- Hard gelatin capsules are prepared using the following ingredients:
- a tablet is prepared using the ingredients below:
- Tablets each containing 60 mg of active ingredient are made as follows:
- the active ingredient, starch and cellulose are passed through a No. 45 mesh U.S. sieve and mixed thoroughly.
- the solution of polyvinylpyrrolidone is mixed with the resultant powders which are then passed through a No. 14 mesh U.S. sieve.
- the granules so produced are dried at 50°C and passed through a No. 18 mesh U.S. sieve.
- the sodium carboxymethyl starch, magnesium stearate and talc, previously passed through a No. 60 mesh U.S. sieve, are then added to the granules which, after mixing, are compressed on a tablet machine to yield tablets each weighing 150 mg.
Abstract
Description
Claims
Priority Applications (8)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
IL12849497A IL128494A0 (en) | 1996-08-30 | 1997-08-28 | Use of inhibitors of pkc for the manufacture of a medicament for the treatment of central nervous system diseases associated with hiv infection |
HU9903911A HUP9903911A2 (en) | 1996-08-30 | 1997-08-28 | Use of inhibitors of pkc for the preparation of pharmaceutical compositions treating central nervous system diseases associated with hiv infection |
CA002263499A CA2263499A1 (en) | 1996-08-30 | 1997-08-28 | Use of inhibitors of pkc for the manufacture of a medicament for the treatment of central nervous system diseases associated with hiv infection |
JP51201298A JP2002514178A (en) | 1996-08-30 | 1997-08-28 | Use of a PKC inhibitor for the manufacture of a medicament for treating a central nervous system disease associated with HIV infection |
BR9711375A BR9711375A (en) | 1996-08-30 | 1997-08-28 | Use of pkc inhibitors for the manufacture of a medicine for the treatment of diseases of the central nervous system associated with HIV infections |
AU42506/97A AU4250697A (en) | 1996-08-30 | 1997-08-28 | Use of inhibitors of pkc for the manufacture of a medicament for the treatment of central nervous system diseases associated with hiv infection |
EA199900244A EA199900244A1 (en) | 1996-08-30 | 1997-08-28 | APPLICATION OF PROTEINKINASE INHIBITORS WITH FOR THE PRODUCTION OF MEDICINES FOR THE TREATMENT OF DISEASES OF THE CENTRAL NERVOUS SYSTEM CONNECTED WITH HIV INFECTION |
NO990947A NO990947L (en) | 1996-08-30 | 1999-02-26 | Use of Inhibitors of PKC in the Preparation of a Medication for the Treatment of Central Nervous System Diseases Associated with HIV Infection |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US2486996P | 1996-08-30 | 1996-08-30 | |
US60/024,869 | 1996-08-30 | ||
US08/917,362 | 1997-08-26 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1998008510A1 true WO1998008510A1 (en) | 1998-03-05 |
Family
ID=21822790
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1997/015583 WO1998008510A1 (en) | 1996-08-30 | 1997-08-28 | Use of inhibitors of pkc for the manufacture of a medicament for the treatment of central nervous system diseases associated with hiv infection |
Country Status (2)
Country | Link |
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AU (2) | AU4250697A (en) |
WO (1) | WO1998008510A1 (en) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6548269B1 (en) | 1995-11-27 | 2003-04-15 | Millennium Pharmaceuticals, Inc. | Ob receptor and methods for the diagnosis and treatment of body weight disorders, including obesity and cachexia |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1995000520A1 (en) * | 1993-06-17 | 1995-01-05 | Ciba-Geigy Ag | Indolocarbazole compound useful as proteinkinase c inhibitor |
EP0657458A1 (en) * | 1993-12-07 | 1995-06-14 | Eli Lilly And Company | Protein kinase C inhibitors |
US5506231A (en) * | 1989-03-31 | 1996-04-09 | The Children's Medical Center Corporation | Treatment of aids dementia, myelopathy and blindness |
-
1997
- 1997-08-28 WO PCT/US1997/015583 patent/WO1998008510A1/en not_active Application Discontinuation
- 1997-08-28 AU AU42506/97A patent/AU4250697A/en not_active Abandoned
- 1997-08-29 AU AU42418/97A patent/AU4241897A/en not_active Abandoned
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5506231A (en) * | 1989-03-31 | 1996-04-09 | The Children's Medical Center Corporation | Treatment of aids dementia, myelopathy and blindness |
WO1995000520A1 (en) * | 1993-06-17 | 1995-01-05 | Ciba-Geigy Ag | Indolocarbazole compound useful as proteinkinase c inhibitor |
EP0657458A1 (en) * | 1993-12-07 | 1995-06-14 | Eli Lilly And Company | Protein kinase C inhibitors |
Non-Patent Citations (3)
Title |
---|
NEREIDA A. PARADA ET AL.: "IL-16 and other CD4 ligand induced migration is dependent upon protein kinase C", CELL.IMMUNOL., vol. 168, no. 1, February 1996 (1996-02-01), pages 100 - 106, XP002052503 * |
PROTUL SHRIKANT ET AL.: "HIV glycoprotein 120 enhances intercellular adhesion molecule-1 gene expression in glial cells", J.IMMUNOL., vol. 156, no. 3, February 1996 (1996-02-01), pages 1307 - 1314, XP002052502 * |
T.WISS-CORAY ET AL.: "Dysregulation of signal transduction pathways as a potentail mechanism of nervous system alterations in HIV-1 gp120 transgenic mice and humans with HIV-1 encephalitis", J.CLIN.INVEST., vol. 97, no. 3, February 1996 (1996-02-01), pages 789 - 798, XP002052501 * |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6548269B1 (en) | 1995-11-27 | 2003-04-15 | Millennium Pharmaceuticals, Inc. | Ob receptor and methods for the diagnosis and treatment of body weight disorders, including obesity and cachexia |
Also Published As
Publication number | Publication date |
---|---|
AU4250697A (en) | 1998-03-19 |
AU4241897A (en) | 1998-03-19 |
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